Fit For Life Exercise Newsletter 6!
Updated: Jan 11
This week we will look at exercises for people with #arthritis in their hands/wrists.
What is Arthritis?
The word arthritis is used to describe pain, swelling and stiffness in a joint or joints. It describes more than 100 conditions that affect the joints, tissue around the joint, and other connective tissues. The most common types of arthritis affecting the hands that we come across are osteoarthritis and rheumatoid arthritis.
Osteoarthritis: A type of arthritis caused by inflammation, breakdown and eventual loss of cartilage in the joints. Also known as degenerative arthritis. This is the most common form of arthritis.
Rheumatoid Arthritis: is an autoimmune disease, which means that the immune system attacks parts of the body—especially the joints. No one is exactly sure what causes rheumatoid arthritis.
Prevalence: According to Arthritis Ireland, about 915,000 people in Ireland are living with arthritis. French et al (2015) found that the overall prevalence of OA in a survey of >50 years old Irish adults was 17.3% for women and 9.4% for men. They reported that prevalence increased with age, with prevalence in those aged ≥ 80 years twice that of those aged 50–60 years. They also found that OA was significantly associated with female gender, older age, pain severity, higher body mass index (BMI), fear of falling, greater number of physical limitations and medication use. The exact incidence of rheumatoid arthritis has not been determined in Ireland though it is estimated to be approx. 1% of the population, and incidence increases with age.
US research tells us that up to 40% of 85-year olds will have symptomatic OA in at least one hand. And that women are nearly twice as likely to develop it as men.
Check out these links for more info.:
- H.P. French, R. Galvin, N.F. Horgan, R.A. Kenny, Prevalence and burden of osteoarthritis amongst older people in Ireland: findings from The Irish LongituDinal Study on Ageing (TILDA), European Journal of Public Health, Volume 26, Issue 1, February 2016, Pages 192–198. https://doi.org/10.1093/eurpub/ckv109
Effects of Arthritis in the hands:
- Pain, stiffness, tenderness, swelling, loss of range of motion, grating sensation, bone spurs at a joint or joints, visible deformity
- Decreased hand function and/or decreased ability in ADL’s (e.g. buttoning clothes, using cutlery, holding zimmer frame/stick)
Benefits of exercise for arthritis in the hands
· Maintain or improve range of motion
· Decreased perception of stiffness and discomfort
· Strengthen the muscles around your joints
· Help you maintain bone strength
· Maintain independence and enhance your quality of life
When to exercise and when not to?
Don’t exercise: During acute flares (periods of inflammation)
o When symptoms are lowest
o When pain medication is most effective
Exercise Adaptations for people with Arthritis (ACSM)
o Begin slowly and progress gradually
o Avoid rapid or repetitive movements of affected joints
o Adapt physical activity to the needs of the individual
o Use the TWO HOUR RULE: The Arthritis Foundation has a “2 Hour Pain Rule”, which they define as “If you have more arthritis pain (as opposed to sore muscles from exercise) 2 hours after you exercise than you did before, you've probably done too much and should cut back a little.
Other helpful suggestions:
- Wider cutlery may help to maintain independence with ADL’s (see image below).
- Hot/cold therapy. Heat can help to relieve feelings of stiffness a little and provide more comfortable feeling (e.g. soaking hands in warm water/using heat pads/cushions). Cold therapy (e.g. applying cold pack) can provide pain relief for a painful swollen joint. However, you must take extreme caution when using hot/cold therapy with Older Adults as they may have decreased sensation and altered skin/tissue health so would be at higher risk for burns!
- Review with the multi-disciplinary team (MDT) e.g. with the nurse to review palm skin integrity; with OT for specialized equipment or maybe a splint/support brace; with the physio for individualized treatment or rehab.; and/or with the GP for pain relief (e.g. pain relief medications or injections).
- Velcro or adapted clothing may enable the person who struggles with small buttons to maintain their independence (see image below).
Newsletter 6 exercise program
Below you will find exercises that will help to maintain or improve range of motion and strength in the hands.
Warm up for 5-10mins, do the exercises, then cool down & stretch for 5-10mins! Do in sitting or standing (depending on individual’s ability), completing 1-3 sets of ~30sec duration on most days. Complete all in a pain free and slow and controlled manner!
You can download the home exercise program here:
Patricia O'Donnell GSR CAT BSc MSc